Our Impact

Hawai’i Public Radio published an article, “Community Paramedicine on the Big Island”, which describes the costs that Hawai’i Island’s most frequent callers incurred to the health care system, often due to non-emergency calls. Hawai’i County Fire Department’s Community Paramedicine program, utilizing W.A.T.E.R.’s Street Sense technology, was able to provide targeted services to those frequent callers as well as the homeless population and other vulnerable patients, keeping them from calling 9-1-1 unnecessarily. This kept more medics available for real emergencies and saved the health care system more than $1 million in 2017.

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Healthcare Informatics published an article on January 5th, 2018, titled “At UC San Diego Health, a Strategic Focus on Getting Providers the Right Information, at the Right Time”. The article discusses the San Diego healthcare market as “advanced” and specifically details the success of the San Diego Health Connect project to adopt the SAFR (Search Alert File Reconcile) model in our local Health Information Exchange. WATER is proud to have participated in the development of this project, and is also pleased to be the only ePCR vendor that offers this level of patient matching functionality to EMS providers in the area.

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An article in the July issue of JEMS highlighted Dr. James Dunford's (City of San Diego Medical Director) efforts to help the vulnerable population in San Diego. Part of these efforts include San Diego's Resource Access Program, which utilizes Street Sense to identify and case manage frequent 911 callers.

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Another article reviewing the results of the University of California, San Francisco evaluation of California's Community Paramedicine Pilot Project was published in JEMS. The article highlights the success of San Diego, who uses W.A.T.E.R.'s Mobile Integrated Healthcare technology. San Diego was able to drastically reduce 911 calls made by frequent callers, prevent unnecessary ED transports, save hundreds of thousands of dollars in healthcare costs, and link patients to more appropriate services.

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The University of California, San Francisco released an “Evaluation of California’s Community Paramedicine Pilot Project” on January 23rd, 2017. This report discussed the initial results of the 13 ongoing pilot projects in the state including in the City of San Diego. Each pilot targets one of six vulnerable population groups. San Diego, whose team utilizes WATER’s Street Sense Mobile Integrated Healthcare technology, has one of two pilots targeting frequent EMS users. The evaluation report found that San Diego was the only frequent EMS users pilot that saw cost savings, in addition to reductions in EMS system use by targeted frequent EMS users. Please refer to page 18 of the evaluation for pertinent cost savings information.

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An article titled “How Community Paramedics Rescue People from San Diego's Streets”, published by the California Health Care Foundation on September 16th, 2016 uses an example of one particular individual to show how the City of San Diego uses Community Paramedicine (alternatively known as Mobile Integrated Healthcare), to help people who are otherwise falling through “gaps” in the healthcare system. The San Diego team uses our Mobile Integrated Healthcare platform, Street Sense, to aid their efforts.

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In September of 2016, Governing published an article, titled “A New Kind of Paramedic for Less Urgent 911 Calls”, that discusses several areas where community paramedics are having a positive impact on local vulnerable populations, including San Diego. In San Diego, the use of data is critical. For San Diego community paramedics, data is tracked, analyzed, and alerted on via Street Sense, our Mobile Integrated Healthcare technology.

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The interoperability of patient care data is a critical issue affecting EMS agencies and hospitals, who wish to share patient data with each other in a seamless electronic health record, but lack the technology to do so. The article “California EMS Agencies Work to Improve Exchange of Health Information with Hospitals”, describes the challenges of setting up a bi-directional flow of patient information, as well as highlights areas that have taken steps towards a solution. This includes San Diego, and the EMS hub hosted by San Diego Health Connect’s HIE. W.A.T.E.R. developers participated in building the EMS hub for San Diego Health Connect, and we are thrilled to see our work become part of the solution for improving patient care. There is still progress to be made, and we look forward to continuing partnerships with EMS agencies and stakeholders to better the exchange of data that saves lives.

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An article published by JEMS on January 15th, 2016, titled “How San Diego EMS Integrated System-Wide Conditional Social Referrals in ePCRs”, describes the positive impact of integrating direct referrals from the city of San Diego’s ePCR program, Street EMS, to San Diego’s 2-1-1 service. The San Diego RAP team uses W.A.T.E.R.’s Street Sense technology for their patient management. Prior to the 2-1-1 integration, EMS Providers could easily create referrals to the RAP team through a connection between Street Sense and Street EMS; however, this often resulted in incomplete referrals that were difficult for the RAP team to follow up on. With the new referral integration, providers must collect more information to make a referral, including patient consent, but the referrals are more complete, and thus more actionable. The new integration furthers the mission of the RAP team to bring critical community stakeholders together to help the city’s most vulnerable populations, and reduce 9-1-1 abuse.

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In the September 27th, 2015 issue of the San Diego Union Tribune, John M. Gonzales wrote another EMS feature highlighting the use of our Street Sense technology: “Paramedic Team Redirects Most-frequent 911 Users”. Per the article, since 2012, the percentage of 911 calls made by frequent users has been reduced from 17.3% of 911 traffic, to 11.6%. The establishment of the Resource Access Program team, aided by the Street Sense technology (which San Diego began using in 2012), have helped to account for this difference. In the article, Street Sense is described as “a one-of-a-kind iPad program used by the community paramedics. The software tracks frequent users’ 911 calls in real time, identifies where these patients can likely be found and offers known medical and social service histories for those people.” A case study of the most frequent 911 user in San Diego is used to illustrate the disconnect between various healthcare social welfare organizations, but also to highlight what stakeholders in San Diego are doing to resolve that disconnect. Here, Street Sense is one piece of a larger puzzle of healthcare and social information exchange.

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The September 25th, 2015 issue of the San Diego Union Tribune features the article “Paramedics Key to Reducing 911 Use”, by John M. Gonzales. This article highlights the San Diego Resource Access Program’s use of Street Sense to help them in their core mission of reducing 911 mega-users, primarily by redirecting those users into social and welfare programs. The article highlights several features of the Street Sense technology used by the RAP team: real-time data, mapping, and alerting technologies. Dr. James Dunford, San Diego’s medical director, is quoted as saying “We’re demonstrating that targeted intervention, using real-time data, can create a surgical strike beam to focus on people who need help the most”. Per the article, the team has saved the city $314,000 from one year to the next, with the help of Street Sense.

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An article published by the United States Health and Human Services Agency, titled “Data-Driven System Helps Emergency Medical Services Identify Frequent Callers and Connect Them to Community Services, Reducing Transports and Costs”, describes in detail the impact Street Sense has had on the Resource Access Program (RAP) in the City of San Diego. This case study looks at the frequent caller problem in the City of San Diego prior-to and after the implementation of Street Sense by the RAP Team, and examines the significant time and cost savings that have resulted.

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In an article published in JEMS on September 14th, 2014, “San Diego’s Resource Access Program Successfully Reduces Costs While Helping Patients”, specific anecdotal evidence is provided to describe the impact that the Resource Access Program, which utilizes Street Sense, has in helping San Diego’s vulnerable populations.

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On February 1, 2014, EMS World published an article titled “How Using Existing Data is Changing the Way EMS Treats Vulnerable Populations”. This article describes the strategy employed by the City of San Diego Resource Access Program Team to use Street Sense to make an impact on the city. The article details how Street Sense (called “eRap” by the San Diego Team), takes existing patient care data and transforms it into actionable information.

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In January of 2013, JEMS published an article “Putting the “RAP” in Rapport”, which describes the background of the San Diego Resource Access Program and how it recognized that a technological gap existed that prevented the program from achieving better results. Street Sense filled this gap, and this article details the various features of Street Sense that are utilized by the San Diego Program to improve care coordination and case management in the city. Per the article, these features include: electronic ranking to ID active callers, electronic discovery of vulnerable individuals, a patient associative CAD view, and alerts.

We are a software development company based in San Diego, California, with decades of combined experience in creating extraordinary technology solutions for various healthcare stakeholders. We were founded by a first responder, giving us a unique perspective on the technology needs of the EMS industry.